this is portifolio of community pharmacy

1. ADDIS ABABA UNIVERSITY COLLEGE OF
HEALTH SCIENCE SCHOOLL OF PHARMACY
Community Pharmacy Attachment in gishen
pharmacy By:
1. Fromi jihad : hsr/ 2810/10
2. Esubalew Shewaye: hsr/ 4331/10

2. Outline

3. Objective
• To observe about community pharmacy setting
practically.
• To appreciate the role of pharmacists in a
community pharmacy.
• To observe and practice how prescription
evaluation and interpretation done
• To know how counseling is given to patients.
• To compare the pharmacy attached gishen
pharmacy with the standard.

4. Introduction
• Community pharmacy also known as retail
pharmacy is the most common type of
pharmacy that allows the public access to their
medication and advice about their health.
• They are health care professions that are close
to the community (public).
• They provide a convenient and less formal
enviroment for those who cannot easily access
or do not choose to acess other kind of health
service.

5. Service in Community pharmacy
• Dispensing OTC and POM drug
• Counceling patients about the drug and other heath
related cases
• Compounding medicines
• Emergency care service (emergency contraception)
and minor ailment management.
• Medication management
• Smoking cessation
• Measurement of blood pressure, cholesterol,
glucose, weight
• Chronic disease management
• Early screening and testing.

6. About Gishen Pharmacy
• Gishen pharmacy was established in 1994. It is a sole
proprietorship company, owned by Mrs. Amakelech Lulu,
who has a pharmacology background.
• The company sector operates in pharmacy, baby products,
and cosmetics.
• The product that the company renders includes, pharmacy
retail, patient medication counseling, compounding
extemporaneous preparations, drug information centre,
and cosmetics retail.
• The company’s vision is to be the leader in the pharmacy
retail outlet in Ethiopia. They want to positively impact
patients and the public at large.
• Meanwhile, the mission is to serve the best of humanity.

7. • The objective of the company is having efficient
and knowledgeable professionals through training,
reliable employees, those who can be trusted with
people’s lives, making Gishen pharmacies efficient
with 21st-century technologies and systems.
• Now it has about seven branches around Addis
Ababa and It employees a total of 143 full-time,
and 1 temporary part-time employee. 80% of
employees are females and under the age of 35
• Gishen pharmacy has been serving the community
for more than 20 years now and it has a lot of
experience.

8. • is located in wider space and can give services for a lot of
costumer at onces and the drugs are assigned based on
pharmacological orders.
• Before you enter to the pharmacy there is a separate
counceling and blood pressure measuring room.
• when you first enter into the stadium gishen pharmacy
cosmotics and other baby products are located on the left
side of the pharmacy, the right side of the cornner is
reserved for the cashier next to the cashier there are
customer waiting area with some chairs.
• There are cardiovascular and endocrine medication on
left side of shelf wit in dispensary area.

9. • On the right side there are ENT, GI drugs, hormones
and on the last side of the shelf there are
dermatological medications. Psycotropics and
narcotics medications are locked on the bottom
lockers.
• At the back there is a large medication storage
area the refrigerator is also placed there which
helps them store temprature sensetive drugs like
epopoiten, vaccines and other medications.
• They also have toilet and sink in a separate room.
On both corners they have security camera for the
safety of both customers and staffs.

10. Service provided
• Dispensing- this is the major activity carried out in
community pharmacy.
• Dispensing non prescription drugs
• They measure blood pressure
• Demonstration and administration of special
dosage form involves
-Eye drop/ointment
-Topical agent
-Liquid oral agent.
• They provide medical equipment like ,insulin
syringes ,first aid equipment ,disposable gloves etc.

11. Observation and discussion
• We were able to observe some available brands.
• We were able to familiarize ourselves with
practice, medication arrangement , and
counseling .
• We were discussing mechanism of action and its
indication of different drugs.
• Generally we observe premises, product,
practice.

12. Strength
• The pharmacy has more than 20 years experience in
these sector.
• The pharmacy has a wider space for both dispencing
and waiting area
• Has seven branches all over Addis Ababa
• Gives credit service for employers of companies and
organizations if companies or organizations registered
to access medication from gishen pharmacy.
• For the safety of both customers and the staff there is
security camera in the pharmacy
• Work with collaboration

13. • The staff who work there are competent
pharmacist
• They contribute well on womens empowerment
• Use computerized software for dispensing and
transactions.
• Quick sorting and separation of expired drugs.
• Recommend patient’s to another pharmacy if
the required drug is stock out or unavailable.

14. Weakness
•
•
• As we observe they lack essential medicines, most
customers were returning without getting their
needed medication
• They don’t give a compounding service
• don't serve clients 24/7
• the building is old so sometimes the floor shakes
when you move
• mostly they don’t hold local products

15. Oppourtunity
• has easily accessible location
• It is located around Gandhi hospital, zeweditu
and tikur anbesa hospital so patients from this
hospital come to this pharmacy.

16. Threat
• Presence of competitive pharmacies nearby
gishen pharmacy like,
-doctor pharmacy
-ghion pharmacy
- kenema pharmacy
- stadium pharmacy
• Lesser availability of medications due to
inflation of the currency in world market that
affect the price of medication.

17. Lesson learned

18. Contribution
• Locating, manipulating and picking medications
to be dispensed.
• Shelving, and labeling mandedications
• Arranging newly arrived stocks in store.
• Recording patient medication information in the
record book.

19. Recommendation
• Better to keep prescription records digitally
• Improve patient waiting area (space) with
sufficient seats.
• Improve the availability of certain drugs with
high demand.

20. Summary
• Community pharmacy is a pharmacy outside of
hospital or health center premises. It mainly deals
with the demand of the local people.
• Dispense prescriptions and over-the-counter
medicines and formulations. ...
• They are also on hand to treat minor ailments and
maintain accurate records and registers for
controlled drugs.
• Gishen pharmacy give services to clients around
Gandhi hospital and other by following the
pharmaceutical standards set for community
pharmacy.

21. Counselling tip monograph

22. • Mechanism of action:
• As with other statins, atorvastatin is a competitive
Inhibitor of HMG-CoA reductase.
• Unlike most others, however, it is a completely
synthetic compound. HMG-CoA
• reductase catalyzes the reduction of 3-hydroxy-3-
methylglutaryl-coenzyme A (HMG-CoA) to
mevalonate, which is the rate-limiting step in
hepatic cholesterol biosynthesis.

23. Indication:
• Reduce the risk of MI and stroke in patients with
CHD and type 2 diabetes mellitus
• primary hyperlipidemia (heterozygous familial and
nonfamilial) and mixed dyslipidemia
• hypertriglyceridemia and primary
dysbetalipoproteinemia
• homozygous familial hypercholesterolemia
• heterozygous familial hypercholesterolemia after
failing an adequate trial of diet therapy

24. Dosage and administration
• Atorvastatin tablet should be taken with a glass of water
and may be taken with food
• (except with grape fruit juice, which at least should be
taken prior 1 hour and after 2 hours) or without foods.
• In hyperlipidemia and mixed dyslipidemia, the usual adult
dose is10 or 20mg once daily for 2-4 weeks .
• When a large reduction in LDL-c of patients is required
40mg once daily for 2-4 weeks can be taken.
• In heterozygous familial hypercholestrolemia pediatric
patients ( 10-17 years of age) the recommended starting
dose is 10mg/ day; the maximum recommended dose is
20mg/day.
• In homozygous familial hypercholesteolemia, the usual
dose is 10- 80mg once daily for2-4 weeks.

25. Special populations
pregnancy
All statins were previously contraindicated inpregnant
women because fetal risk was thought to outweigh any
possible benefit. However, the totality of evidence to
date
indicates limited potential for statins to cause
malformations and other adverse
embryofetal effects.
• Lactation
• Distributed into milk in rats; may distribute into milk in
humans. Use is contraindicated in nursing women;
women who require atorvastatin therapy should not
breast-feed their infants.

26. • Caution:
• Contraindication:
• Active Liver Disease which may include
Unexplained Persistent Elevations of Hepatic
Transaminase Levels
• Hypersensitivity to any Component of this
Medication
• Pregnancy
• Nursing Mothers

27. Warning
• Skeletal muscle effects (e.g., myopathy and
rhabdomyolysis)
• Rare cases of rhabdomyolysis with acute renal failure
secondary to myoglobinuria. In cases of myopathy or
rhabdomyolysis, therapy should be temporarily
withheld or discontinued.
• Persistent elevations in hepatic adjunct therapy to
diet to: transaminases can occur. Monitor liver
enzymes before and during treatment.
• A higher incidence of hemorrhagic stroke was seen in
patients with stroke

28. Side effects:
Common side Effects
• Nasopharyngitis,
• arthralgia,
• diarrhea,
• pain in extremity
• urinary tract infection
• dyspepsia

29. Advice to patient:
• Importance of adhering to nondrug therapies and
measures, including adherence to a heart-healthy
diet, regular exercise
• Report or contact physician if there is risk of
myopathy and/or rhabdomyolysis, adverse hepatic
effects, cognitive impairment.
• Increased risk of hyperglycemia ( monitor glucose
level concentration)
• Importance of advising women and adolescent girls
to avoid pregnancy
• Importance of avoiding breast-feeding during
therapy.

30. Reference
1.Community pharmacy practice lectures note
2.Medication leaflet
3.Uptodate 2018
4.Drug-Information hand- Book-Lexicomps pdf